Clinical Rhinology

Register      Login

VOLUME 13 , ISSUE 1 ( January-April, 2020 ) > List of Articles

Original Article

Clinical Study of Rhinogenic Headache and Its Management in Adults

Hosalli Kumaraswamy Nagarathna, Tejaswini Honnegowda

Citation Information : Nagarathna HK, Honnegowda T. Clinical Study of Rhinogenic Headache and Its Management in Adults. Clin Rhinol An Int J 2020; 13 (1):5-8.

DOI: 10.5005/jp-journals-10013-1372

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Introduction: Rhinogenic headache is the secondary headache caused by various sinus pathologies. Aim and objective: To study various etiologies of rhinogenic headache and outcome of its management. Materials and methods: This was a prospective study on 60 patients with rhinogenic headache, presenting to the ENT department of Akash Institute of Medical Sciences and Research Centre, Karnataka, India. All patients with rhinogenic headache underwent Diagnostic Nasal Endoscopy (DNE) and X-ray of the paranasal sinuses. High-resolution computed tomography paranasal sinuses were done in patients who were to be managed surgically. Patients were managed according to the etiology by a conservative or surgical method and followed up for 6 months to evaluate the treatment outcome. Results: All the patients were adults, predominantly males 58% and 41% were females. Fifty percent of patients were in the age group of 20–30 years. 38.3% of patients had deviated nasal septum as the cause of rhinogenic headache, while chronic rhinosinusitis 28.3%, acute rhinosinusitis 16.7%, nasal polyposis 10%, allergic rhinitis 3.3%, and concha bullosa 3.3%. Twenty percent of patients underwent conservative management while 80% underwent surgical management like septoplasty, inferior turbinoplasty, and functional endoscopic sinus surgery. 61.7% had complete relief from headache while 31.3% had significant relief from pain. Conclusion: Rhinogenic headache is an important etiology of secondary headache and significantly affects the quality of life. Diagnostic difficulties do exist and the otolaryngologist plays a pivotal role in instituting appropriate treatment. The relevant treatment of the underlying etiology provides a more effective outcome in a patient with rhinogenic headache.

  1. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders. 3rd ed. Cephalalgia 2018;38(1):1–211. DOI: 10.1177/00034894880970s501.
  2. Stammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 1988;134(5_suppl):3–23. DOI: 10.1177/00034894880970s501.
  3. Herzallah IR, Hamed MA, Salem SM, et al. Mucosal contact points and paranasal sinus pneumatization: does radiology predict headache causality? Laryngoscope 2015;125(9):2021–2026. DOI: 10.1002/lary.25194.
  4. De Corso E, Kar M, Cantone E, et al. Facial pain: sinus or not? Acta Otorhinolaryngol Ital 2018;38(6):485–496. DOI: 10.14639/0392-100X-1721.
  5. Masood A, Moumoulidis I, Panesar J. Acute rhinosinusitis in adults: an update on current management. Postgrad Med J 2007;83(980):402–408. DOI: 10.1136/pgmj.2006.054767.
  6. Badran HS. Role of surgery in isolated concha bullosa. Clin Med Insights Ear Nose Throat 2011;4:13–19. DOI: 10.4137/CMENT.S6769.
  7. Kumar P, Chawla P. A correlative study of sinusitis versus headache. Indian J Otolaryngol Head Neck Surg 2000;52(2):125–127. DOI: 10.1007/BF03000328.
  8. Kaur A, Singh A. Clinical study of headache in relation to sinusitis and its management. J Med Life 2013;6(4):389–394.
  9. Kadah SS, Mokhemar S, Alkholy TE, et al. Role of endoscopy in rhinogenic contact headache not responding to medical treatment. Egypt J Otolaryngol 2019;35(3):256–261. DOI: 10.4103/ejo.ejo_6_19.
  10. Altin F, Haci C, Alimoglu Y, et al. Is septoplasty effective rhinogenic headache in patients with isolated contact point between inferior turbinate and septal spur? Am J Otolaryngol 2019;40(3):364–367. DOI: 10.1016/j.amjoto.2019.02.002.
  11. Karataş D, Yüksel F, Şentürk M, et al. The contribution of computed tomography to nasal septoplasty. J Craniofac Surg 2013;24(5):1549–1551. DOI: 10.1097/SCS.0b013e3182902729.
  12. Hammad MS, Gomaa MA. Role of some anatomical nasal abnormalities in rhinogenic headache. Egyptian J ENT Alli Sci 2012;13(1):31–35. DOI: 10.1016/j.ejenta.2012.01.006.
  13. Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache 1995;35(7):404–406. DOI: 10.1111/j.1526-4610.1995.hed3507404.x.
  14. Koch-Henriksen N, Gammelgaard N, Hvidegaard T, et al. Chronic headache: the role of deformity of the nasal septum. Br Med J (Clin Res Ed) 1984;288(6415):434–435. DOI: 10.1136/bmj.288.6415.434.
  15. Huang HH, Lee TJ, Huang CC, et al. Non-sinusitis-related rhinogenous headache: a ten-year experience. Am J Otolaryngol 2008;29(5):326–332. DOI: 10.1016/j.amjoto.2007.10.001.
  16. Gryglas A. Allergic rhinitis and chronic daily headaches: is there a link? Curr Neurol Neurosci Rep 2016;16(4):33. DOI: 10.1007/s11910-016-0631-z.
  17. Rai U, Devi P, Singh N, et al. Contact point headache: Diagnosis and management in a tertiary care center in Northeast India. J Med Soc 2018;32(1):51–56. DOI: 10.4103/jms.jms_69_16.
  18. Behin F, Behin B, Bigal M, et al. Surgical treatment of patients with refractory migraine headaches and intranasal contact points. Cephalalgia 2005;25(6):439–443. DOI: 10.1111/j.1468-2982.2004.00877.x.
  19. Peric A, Rasic D, Grgurevic U. Surgical treatment of rhinogenic contact point headache: an experience from a tertiary care hospital. Int Arch Otorhinolaryngol 2016;20(2):166–171. DOI: 10.1055/s-0036-1578808.
  20. Harrison L, Jones NS. Intranasal contact points as a cause of facial pain or headache: a systematic review. Clin Otolaryngol 2013;38(1):8–22. DOI: 10.1111/coa.12081.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.